Edward Madden

Edward has more than 31 years of experience in the healthcare industry as an analyst, project manager, Executive Director, consultant, facilities planner, and LEAN coach. He has experience across multiple healthcare lines of business, including Medicare, Medicaid, and Federally Qualified Health Centers, and commercial plans. He has also served as the chairman of a large inner city neighborhood development corporation dealing with the source of many of the social determinant issues that challenge access to care and the culture of seeking episodic care instead of preventive care.   

Experience

  • Executive Director responsible for managing monthly enrollment transactions for 600,000 commercial, Medicaid, and Medicare members. 
  • Executive Director responsible for managed the billing, processing and collection of $2.7 billion in revenue annually from the employers, individuals, federal, state, and local governments. 
  • Director responsible for managing the processing of $470 million in revenue annually from CMS for services provided to Medicare managed care enrollees.   
  • Lead Plan Manager for many Medicare managed care plans and systems.  Areas of regulatory oversight included Administration & Management, Delivery System Analysis, Delegation Arrangements, Provider Contracting, Information Systems, Quality Assurance / Improvement, Utilization Management, Appeals & Grievances, and Credentialing.   
  • Investigatory reviewer for CMS concerning problem plans

Qualifications

  • 31+ years healthcare experience
  • LEAN Coach

Education

  • Bachelor of Science Mathematics, Minor Sociology-Morgan State University in Baltimore 
  • Business Literacy- University of Washington School of Business